Ex-state Sen. Raphael Musto, likely nearing death from end-stage cancer, can return home to be treated by his local doctors, a federal judge ruled Friday.

During a brief court hearing, Senior U.S. District Judge A. Richard Caputo ordered Mr. Musto's immediate release from a federal medical prison in North Carolina, where the judge had sent Mr. Musto for evaluation after determining he was not competent to stand trial on corruption charges.

"It's obvious this is a dire circumstance," Judge Caputo said of Mr. Musto's rapidly deteriorating health.

Earlier Friday, Mr. Musto's local oncologist Dr. David Greenwald of Pittston penned a letter to Judge Caputo telling the judge that Mr. Musto is dying from Stage IV lymphoma and likely has only weeks or months to live. The letter, which said Mr. Musto's only treatment option may be hospice and not medical intervention, was admitted as an exhibit during Friday's hearing in federal court.

Mr. Musto appeared via video conferencing from Federal Medical Center at Butner in Granville County, N.C. He wore a tan, long-sleeved shirt and sat slouched back in a chair at a conference table. He complained several times that it was difficult to hear the proceedings.

Members of Mr. Musto's family, who attended the hearing, will pick Mr. Musto up at the facility, the judge said.

Last week, attorneys for the 85-year-old former lawmaker asked for his immediate release due to the recent cancer diagnosis. Federal prosecutors did not object, though they asked a judge for Mr. Musto's doctors to promptly provide the court with status updates on his condition after their evaluations.

In his letter to Judge Caputo, Dr. Greenwald said he made his prognosis based on medical records supplied from FMC Butner. He said he would be able to provide the court with more information following a face-to-face evaluation.

"I can say with reasonable certainty that a gentleman of Mr. Musto's age of 85, with the underlying comorbidity of advanced liver disease, the survival is likely to be short and counted in weeks or months and not years," Dr. Greenwald wrote.

Placing Mr. Musto in hospice care may be the only option, Dr. Greenwald said.

Mr. Musto and his family will soon decide if he should undergo treatment, like chemotherapy, which might not be an option given his age and other health concerns, Dr. Greenwald said.

"At this point in time, it is clear that Mr. Musto has a very poor prognosis," Dr. Greenwald wrote.

Judge Caputo acknowledged Mr. Musto and his family have "substantial decisions" to make in the next few weeks. He asked Mr. Musto's defense team to provide him a status report on Mr. Musto's health within 30 days.

Mr. Musto reported to FMC Butner for evaluation after Judge Caputo ruled in January he was not competent to stand trial. The former lawmaker's four-month evaluation period was set to expire on June 2.

A federal grand jury indicted Mr. Musto on bribery and kickback charges on Nov. 23, 2010, one week before his previously announced retirement after 28 years in the state Senate. Ever since, the Pittston Township Democrat fought relentlessly to avoid trial and stay out of prison, arguing he was too old and too sick.

Prosecutors accused Mr. Musto of receiving $35,000 in cash, free construction services and Christmas gifts from Mericle Construction Co. as a reward for his support of state grants for a multimillion-dollar development in Mr. Musto's district. They filed additional charges in October 2012 and November 2013, alleging Mr. Musto solicited and accepted cash bribes from others seeking his influence, one of which has been identified by municipal officials as once-prominent engineer Michael Pasonick.

It was not immediately clear when Mr. Musto's family would pick him up to bring him home. As of Friday evening, he was still listed as inmate No. 69735-067 at FMC Butner.

Contact the writer: bkalinowski@citizensvoice.com, @cvbobkal

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